Meet Pattie Jakel, Oncology Clinical Nurse Specialist

Today, Jakel is the CNS in a 26-bed Oncology Unit at Santa Monica-UCLA Medical Center and Orthopaedic Hospital. Following her around for a day, it’s obvious that she has earned both the respect and friendship of her staff, blending professionalism with a lighter, personal touch. During a typical morning shift, she jokes as she looks over statistics with Terry Taylor, the ACP who is on the verge of retirement. Roaming the halls, Jakel makes frequent stops for consultations with nurses, orderlies and resident doctors. As expected, not everything runs as smoothly as she would like. She rubs her forehead in frustration when given some bad news about a mistake almost made in a patient’s medication. She knocks on the door of a patient she describes as particularly elderly and frail, to make sure he hasn’t had an accident. “Falls are a huge issue,” she explains. “Medicare will not cover falls, bedsores, things like that. The hospital is responsible if someone hits their head, gets a hematoma and dies.” Emerging from the patient’s room, she continues, “The first line of defense is the family, to remain at the bedside, but sometimes it’s hard to get family members to stay here. It’s like a break for them.”

Jakel stops to mentor Monique Acosta, an RN, and Monica Coles, a nursing student. The conversation turns to a 19-year-old patient who recently died from gastric cancer. As they speak, a condolence card is being passed around and signed by everyone in the unit. “Ashley was an angel, and that’s a word I don’t often use to describe patients,” says Jakel. “She was so sweet and so brave, she never once complained….”

Dr. Michael Marra, a professor of Asian Languages and Culture at UCLA, is in the advanced stages of Leukemia. In a soft voice, he describes the treatment he is receiving as “stunning, just stunning,” praising the compassion he has found. “You’re in the dark tunnel now, “ Jakel tells him. “We’re going to get you through it.” She listens intently as Marra shares his views on life and death, which have been influenced by his interest in Eastern philosophies. “What is life? Life is something beautiful that you experience, and then it’s gone. There’s nothing strange about it.”

Their conversation turns to issues of quality of life and mercy. Jakel tells him that she has worked with elderly patients who, in the advanced stages of illness, are ready to die, but whose families influence them to do everything possible to prolong their lives. “We don’t let people die anymore. I struggle everyday with people well into their 80’s.” Marra shakes his head sadly. “It’s a natural process,” he says quietly.

Jakel estimates she has seen “hundreds of deaths in 27 years” on the job. “It doesn’t get easier; it gets different,” she says. “I have other areas where I can put my emotions now. I still cry. When Ashley died, I cried for days.” She shares stories about work with her children, believing it will help make them more compassionate. At the hospital, this open expression of feeling for her patients is not lost on her young mentees, who quickly discover that in the life-and-death world of oncology, tempering one’s compassion with the steely resolve to persevere is perhaps the greatest skill they can develop.